大黄牡丹皮汤加味治疗急性阑尾炎的Meta分析*

目的系统评价在常规西医治疗基础上联合大黄牡丹皮汤治疗急性阑尾炎的有效性及安全性。方法 计算机检索中国知网（CNKI）、中国生物医学文献数据库（CBM）、维普（VIP）、万方（WanFang）数据库中关于大黄牡丹皮汤治疗急性阑尾炎的随机对照实验，检索时间为建库至2019年6月23日，由2名研究者分别独立筛选文献、提取资料并评价纳入文献的偏倚风险，用Revman5.3进行数据分析。结果 共纳入15篇文献，1 436名患者。Meta分析提示：与对照组相比，实验组能提高临床有效率［RR=1.20，95%CI（1.15，1.25），P<0.000 01］，减轻患者腹痛症状［RR=-1.65，95%CI（-2.10，-1.20），P<0.000 01］及压痛症状持续时间［RR=-2.03，95%CI（-2.75，-1.31）， P<0.000 01]，促使体温尽早恢复正常［RR=-2.14，95%CI（-2.45，-1.83），P<0.000 01]，降低患者炎症指标，包括白细胞数［RR=-1.58，95%CI（-2.43，-0.73），P<0.000 3]、中性粒细胞比值［RR=-4.50，95%CI（-5.95，-3.05），P<0.000 01]及血清CRP［RR=-2.17，95%CI（-2.53，-1.81），P<0.000 01]。结论 在常规西医治疗基础上联合大黄牡丹皮汤治疗急性阑尾炎患者，能进一步提高临床疗效，缩短患者局部（腹痛和压痛症状）及全身（体温）持续时间，降低炎症指标，但由于纳入文献质量参差不齐，上述结论仍需更高质量文献支持。

Systematic Review and Meta-analysis of Dahuang Mudanpi Decoction on Acute Appendicitis

Objective To systematically review the effectiveness and safety of Dahuang Mudanpi Decoction on acute appendicitis. Methods Four Chinese databases(CNKI, CBM, VIP, WanFang) were searched for the study of randomized controlled trials(RCTs) of Dahuang Mudanpi Decoction on acute appendicitis. Two researchers independently screened the literature, extracted effective data, assessed the risk of bias, and analyzed the data by RevMan 5.3 software. Results Eventually fifteen literatures were included containing 1 436 patients. The Meta-analysis indicated that compared with control groups, the trail groups could improve the clinical efficacy in acute appendicitis patientsRR=1.20, 95%CI(1.15, 1.25), P<0.000 01], promote the temperature to return to normalRR=-2.14, 95%CI(-2.45, -1.83), P<0.000 01], abridge the duration of acute abdominal painRR=-1.65, 95%CI(-2.10, -1.20), P<0.000 01] and tenderness RR=-2.03, 95%CI(-2.75, -1.31), P<0.000 01]. Meantime, inflammation markers declined, including the white blood cell countsRR=-1.58, 95%CI(-2.43, -0.73), P=0.000 3], percentage of neutrophilsRR=-4.50, 95%CI(-5.95, -3.05), P<0.000 01], high-sensitivity C-reactive proteinRR=-2.17, 95%CI (-2.53, -1.81), P<0.000 01]. Conclusion Dahuang Mudanpi Decoction could further improve clinical efficacy compared with routine treatment alone, abridge the duration of partial (acute abdominal pain and tenderness) and systematic (temperature) symptoms, reduce the inflammation markers. Literature of higher quality is still needed to support the conclusion due to the uneven quality of the literature.